Discussion

This page discusses alternative views of myopia prevention. Sometimes the views align with this site and current research, sometimes they drift far afield. One might reasonably ask why I've given so much space to views that are often less substantiated than research on this site. The answer is that I believe it would be a mistake to ignore viewpoints that I don't necessarily agree with. Scientific thought has a history of both charlatans and subpresssion of alternative viewpoints (by both other scientists and by society) that turn out to be true. Since this is a web site, people reading it will compare it to other sites they have found. The good thing is that reasoned thought and discussion can determine theories that can be tested to see if they are factual.

Here is a short list of three alternative view web sites, most including links to other sites. They stand on their own - I have no connection to them. They are of interest to anyone seeking a complete history of myopia prevention efforts. I certainly do not disagree with everything on the sites, and although I consider them "alternative views", they would probably, at best, consider this site the alternative view. All is not chaos. Read a lot, both on this site and elsewhere, become educated, and act on your knowledge.

http://www.i-see.org/ Alex Eulenberg has the International Society for the Enhancement of Eyesight, which is "a web site and a mailing list dedicated to promoting better natural eyesight for everyone!" A site with essays, books, reviews, explanations and other content.

http://www.myopia.org/ Don Rehm has the International Myopia Prevention Association and considers the use of plus lenses, generally +3.00, on all children at the first sign of myopia to be preventive. He is strongly opposed to how current eye doctors normally treat myopic children.

http://www.chinamyopia.org/mainenglish.htm A Chinese site partially translated into English. Run by Han Bossino, a journalist, and Steve Leung, an optometrist. The portions translated into English include sections on how to prevent nearsightedness and a section for emails.

Facts or Placebos?

Science is the study of facts. If you search the internet for help with your myopia, you will be swamped by people offering you placebos instead. You can try all the eye blinking, palming, Bates' methods, See Clearly Methods, pinhole glasses, relaxation, sunning, breathing exercises you want and you can eat tea and honey and supplements and vitamins and herbs, but you can't control the facts. Until you understand that facts are discovered, not created, you will be at the mercy of an amazing array of charlatans offering you cures for everything from myopia to cancer. They all will tell you that their method has worked (they say so) and so it will work for you. And huge numbers of you will fall for it. Why? Because you want help and you can't find it wrapped up like you think it should be. We as a society and many individuals have the desire to be healthy and many blame science for offering us unhealthy options. So people flock to alternative options. They try the placebo, the blinking or the relaxation and feel that maybe their vision DID get better. Placebos sometimes cure people of some conditions. That's a scientific fact also. That doesn't mean you should use them on your child that you are trying to prevent from becoming myopic. Stick to the facts.

Who to trust? International research or one web site?

When you are looking for information, you have learned to look for a source you can trust. This site is here to tell you that thousands of people all over the world are working in research facilities, universities and private practices to understand the development and prevention of myopia. They are connected by journal articles and meetings to discuss, debate and determine areas of future research. The goal is to understand a phenomena that is getting worse, to the point that some have termed it a myopia epidemic. More progress has been made in the last 10 years than in the previous 100 and the results are exciting. You can read over a hundred of their articles under the Research menu, nearly all of them written in the last ten years as results drive further research.

These are not the theories of one person on the internet with unverified results, claiming that doctors are lying to you and then telling you to buy their book or device that they claim will cure you. These are results that are being tested in many different labs and offices around the world. The final results are not in yet, but the current results are strong enough to act upon. There is help available for the developing myope.

What is science?

Before one can talk about pseudo (false or fake) science, one needs to understand how science operates. Implicit in the definition of science is the use of the scientific method which encompasses a body of techniques used to arrive at a truth. Most of the references to studies on this site are from what are called refereed or peer-reviewed scientific journals, meaning that the articles must pass some minimum standard for the quality of the work. That standard, among other things, requires the work to be very specific in its descriptions of what was done and how the results were evaluated so that others can duplicate the findings. Duplication of results is the gold standard. If others can not duplicate your results, they just didn't happen.

There are those who refuse to believe a medical treatment has been proven to have no benefit because they have seen results that contradict the conclusions. An example relevant to myopia is the belief that rigid contact lenses significantly slow or stop myopia progression. This has been proven false and yet many doctors will continue to offer it as a means to control myopia. Most do so because they haven't seen the studies, but others will elect to ignore them. I am only hopeful that our educational system can continue to create critical thinkers who are willing to evaluate the evidence. I hope this site allows those willing to consider the evidence to find the truth that is helpful for their situation.

Science is fluid and changes its mind with further evidence

Many people do not understand that science is a fluid process. A scientist is always able to modify conclusions based on further evidence. An example related to eye care is indicative of how the process often works. Several years ago a study was undertaken in response to the question "Do night lights in an infant's bedroom cause the child to develop myopia in later years?" The study, not as well designed as it might have been, simply asked over 400 parents bringing their children in for eye exams if night lights were used when the child was under two years of age. Yes, it turned out, those that had night lights were much more likely to now be myopic. The results were published, it was picked up by the national media and suddenly parents were concerned that they were ruining (or had ruined) their children's future vision. According to a news report (CNN) at the time, the author warned that the finding was preliminary and yet to be proven, but that didn't stop many parents from having their children start sleeping in the dark.

Further studies were done to duplicate the results and further identify the reasons. As it turned out, the effect was real, but it wasn't due to the night lights. Parents who were myopic were more likely to leave a night light on and myopic parents are more likely to have myopic children. The myopic parents just couldn't see as well at night without their glasses, so they left a light on more often. Comments were printed back and forth in the original journal and the issue of night-light myopia died away. Science works that way. A finding is published for others to study and verify. The results have to stand up under scrutiny or they won't be accepted. One certainly doesn't want to warn parents away from night lights if there is no proof of a problem. Read about How Science Works: The Story of Night-Light Myopia in the Research section.

This example illustrates the most common reason for un-scientific conclusions one sees in print and on the internet, namely the assumption that two things that happen at the same time or in sequence means that one causes the other. In more precise language, the fact is that correlation (two things happening together) does not imply causation. One event may cause another to happen, but one can not make that conclusion unless other factors are eliminated from being possible. That's where the scientific method kicks in and guides how a topic is studied.

Testimonials

Another example is useful in considering pseudo-science: the use of testimonials to prove a point. Testimonials are very useful in that they let a person learn how others have reacted to something of mutual interest. Let's make up an example of a testimonial: "I've followed the XYZ method for years and my eyes have gotten better. Not only do they feel better, but my vision has improved so much I don't need any prescription glasses to drive any more. I heartily endorse XYZ."

There is no reason to doubt the person and there actually may be something to their story. It just doesn't meet the criteria needed to recommend XYZ as a treatment unless one is willing to accept the known consequences (cost, time, effort, etc.) and the possible unknown consequences, including the possibility it might not work or even make the problem worse. A scientifically designed study would need to be done to identify if the reaction that this person had was actually due to the XYZ method. Perhaps, like the night light, there is another explanation. If the treatment is proven, then the testimonial is much more worthwhile as an indication of how someone else might react. Testimonials of unproven techniques are merely entries in a diary.

The Bates Method

What does all this talk about science have to do with myopia? Probably the biggest body of work written for the non-scientist on myopia has to do with a publication first printed in 1920. It's findings have been refuted for over eighty years and it falls into the category of pseudo-science. That hasn't stopped it from being continually brought forward as facts to help the myope. There is something psychologically intoxicating about accepting facts that are known to only a select few (those reading the web site), especially when one is told that scientists are ignoring the "facts". Almost everyone feels taken advantage of at times so being told that the "establishment" is against them feels right to many . Feelings become more important than facts.

William Bates self-published a book called Perfect Sight Without Glasses in 1920. Its copyright expired in 1948 and is currently in the public domain according to the oddly named Imagination Blindness web site. http://www.iblindness.org/books/bates/ (Copy and paste the link if you are interested in reading the book. The web site is fairly typical of those who consider Bates an expert to be followed.) Bates was an eye doctor born in 1860 at the beginning of the American Civil War and practiced ophthalmology at a time when it was only recently decided that microorganisms (germs) could cause disease. He thought he could determine if people had abnormal vision by looking at them or a photograph of them. He became convinced that glasses were never necessary and that myopia was caused by straining to see clearly. The major basis of his treatment was to throw away the glasses and do relaxation procedures designed to relax the tension believed to have produced the myopia. He published pictures of people and animals with expressions that he labeled as normal or strained, saying the strained expressions showed myopia. The cure, basically, was to stop trying so hard to see.

He supported his theories with a misunderstanding of the anatomy of the eye, not surprising considering the tools he had available at the time to study such a small, intricate structure. He believed that eyes focused by use of the large muscles external to the eye (thus creating the "strained" look on people and animal faces), which is not correct. Focusing, called accommodation, is controlled internally in the eye. That, by itself, would not necessarily discredit his theories, but it is an indication of the poor science that he used to support his ideas. Although later advocates of his beliefs have selected those that best support their own ideas, it is informative to quote a couple of sentences from his book: (chapter XVI) "After looking at the sun most people see black or colored spots which may last from a few minutes to a year or longer, but are never permanent. These spots are also illusions, and are not due, as is commonly supposed, to any organic change in the eye. Even the total blindness which sometimes results, temporarily, from looking at the sun, is only an illusion." This is outrageously wrong - permanent blind spots can be caused by staring at the sun - the eye is fried as easily as if a magnifying glass were focused onto it. The change is a permanent burn. Do not look at the sun. At least this portion of his system is not often quoted today.

What else did Bates believe? Here's some more examples: People became myopic if they told a lie - page 111. (He actually probably measured variable normal focusing changes.) Stars don't twinkle for someone with normal vision. (They actually do twinkle due to heat waves in the atmosphere.) Floaters are optical illusions caused by eyestrain. (They are real - caused by small objects floating in the vitreous in the middle of the eye, casting shadows that are seen.) Refractive error gets better with memory - Chapter XII. (Actually blur interpretation gets better - not the amount of myopia. If you practice with blurred eye charts, you get better at guessing what the blurred letters are. This doesn't mean you are less myopic but rather just a better guesser.) Scientific studies depend on optical measurements of the eye's focus and length that do no depend on the person reporting clarity. Only then can you determine if the eye really is changing focus.

People who follow Bates often term their methods the "Bates Method". They continue to write lots of books and sell lots of programs, perhaps not mentioning Bates until fairly far into their explanations (if at all) of why their method is valid. People continue to buy them because they want to believe that there is a cure for their problems and it feels right to be told that the reason they don't get help from their doctors is that there is a conspiracy to keep them visually handicapped by the medical profession. If not an outright conspiracy, the thinking goes, then at least it is their doctor not understanding their condition or not wanting to help it in any way except to profit from selling surgery, glasses or contact lenses. The fact that they go back to medical ideas that are 100 years old is overlooked in light of all the new, modern packaging, presenting the ideas on CD, manuals, books, internet video, internet stores and even training retreats. Here's a link to a page describing Bates' theories (among other things.) And here's another one specific to Bates.

Bates got it wrong. Read about it if you wish, but don't stop your education with data from 80 years ago. Decades of advancement in biology and hundreds of research projects looking into myopia can not be ignored.

Palming

It is obvious that Bates was wrong about a lot of things. The logical question is whether he was right about anything that is actually useful to the modern reader. He states (chapter XII): "All the methods used in the cure of errors of refraction are simply different ways of obtaining relaxation..." This is essentially the whole theme of his method: relaxation. Does relaxation help vision? One often mentioned method to relax is "palming", basically closing the eyes, covering them with the palms of your hands and trying to imagine a "perfect black" that is supposedly an indication of perfect vision. Healthy eyes don't see a perfect black however, so the goal is suspect to begin with. However, there is no harm in palming as described. Although Bates said not to put pressure on the eyes, the report of vivid colors using this technique is most likely a phenomena created by inappropriate pressure. Do not press on your eyes - it creates real problems. Does no-pressure palming help anything? It may help to relax your body - just as closing your eyes helps you go to sleep. Enjoy it if you wish, it doesn't stop you from getting more nearsighted.

Relaxation

The essence of Bates' technique is relaxation of the eye. Different methods are described, all based on the fallacy that the muscles on the outside of the eye that turn the eye in different directions are also responsible for focusing the eye. Let's assume that he got the anatomy correct however: Is there any advantage to relaxing the actual focusing muscle, the ciliary body? The evidence that is usually cited why people should relax their eyes is that people who read (muscle work) become myopic and the drug atropine that stops the eye from focusing to read also stops myopia from developing.
Let's look at both of these ideas.

The idea of not reading is usually modified to "don't read without bifocals or reading glasses". Since culturally we generally can not avoid reading, the idea is to relax the focusing muscle when reading. Reading glasses do that. There are two problems with the idea: 1) reading doesn't cause myopia. 2) reading glasses don't stop myopia progression. You can read about bifocals and reading glasses under the Lenses section of the Treatments menu. You can read about near (close) work and it not causing myopia in the Research menu under Environment.

The facts that the actual focusing muscle (ciliary body) can't function when atropine eye drops are applied and people given the drops do not develop more myopia are often cited as evidence that focusing is responsible for myopia progression.
That has not been proven and in fact the majority of evidence so far indicates it is not true.